Medicaid Utilization Before and After a Natural Disaster in the 2016 Baton Rouge-Area Flood.

Objectives. To understand changes in behavioral health services utilization and expenditures before and after natural disaster with an adult Medicaid population affected by the Baton Rouge, Louisiana-area flood (August 2016).Methods. We examined de-identified behavioral health claims data for Medicaid-insured adults in the affected region for 10 months before and after flooding (October 2015-June 2017). This constituted 273 233 provider claims for 22 196 individuals. Claims data included patient gender, behavioral health diagnoses, treatment dates, and costs. We made adjustments for Medicaid expansion by using monthly enrollment data.Results. Overall, most male patient behavioral health care visits were for substance use disorders (33.6%) and most female patient behavioral health care visits were for depression-related disorders (30%). Both diagnostic categories increased after the flood by 66% and 44%, respectively. Expansion accounted for a 4% increase in claims. Postflood claims reflected 8% to 10% higher costs.Conclusions. Greater amounts of behavioral health care services were sought in all 10 months of the postflood study period. We observed gender differences in use of services and diagnoses. Behavioral health care services following natural disasters must be extended longer than traditionally expected, with consideration for specific population needs.

Achieving successful evidence-based practice implementation in juvenile justice: The importance of diagnostic and evaluative capacity.

Evidence-based programs (EBPs) are an increasingly visible aspect of the treatment landscape in juvenile justice. Research demonstrates that such programs yield positive returns on investment and are replacing more expensive, less effective options. However, programs are unlikely to produce expected benefits when they are not well-matched to community needs, not sustained and do not reach sufficient reach and scale. We argue that achieving these benchmarks for successful implementation will require states and county governments to invest in data-driven decision infrastructure in order to respond in a rigorous and flexible way to shifting political and funding climates. We conceptualize this infrastructure as diagnostic capacity and evaluative capacity: Diagnostic capacity is defined as the process of selecting appropriate programing and evaluative capacity is defined as the ability to monitor and evaluate progress. Policy analyses of Washington State, Pennsylvania and Louisiana's program implementation successes are used to illustrate the benefits of diagnostic and evaluate capacity as a critical element of EBP implementation.

Examining the validity of the Structured Assessment of Violence Risk in Youth (SAVRY) for predicting probation outcomes among adjudicated juvenile offenders.

The current study examined the ability of the Structured Assessment of Violence Risk for Youth (SAVRY), a standardized risk assessment instrument, to predict probation outcomes among a sample of 158 adjudicated juvenile offenders placed on probation. Traditionally, the SAVRY has been used to measure violence risk among adolescents after release from custody. More recently, a delinquency risk measure based on SAVRY responses was developed, which could be useful for other types of outcome. This study examined the predictive validity of both summary risk ratings (SRR) for probation outcomes, including the reason for terminating probation and length of time on probation. A number of bivariate analyses and Cox regression models provided preliminary support for the ability of the nonviolent delinquency SRR, and modest support for the violence SRR, to predict probation outcomes. The implications for use of the SAVRY SRRs during juvenile justice system decision-making and recommendations for future research are discussed.